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Employer supports improve function and productivity of workers with arthritis

Study finds not everyone needs accommodation, and that different accommodations meet the needs of different individuals

It's often a struggle for people with arthritis to manage their health condition and not let it interfere with work. Although treatment options have improved, and symptoms of pain and stiffness are often intermittent, the chronic condition can result in missed meetings, late starts, and unproductive or missed days when flare-ups occur. Without workplace support, a diagnosis of arthritis can even end up forcing people out of a job.

However, a new study about workplace supports for people with arthritis suggests that many affected workers don’t feel they need frequent help. The study, conducted by the Institute for Work & Health (IWH), also finds that the benefits and accommodations needed—ranging from extended health benefits to flexible working hours—are often already being offered by employers and that people who are able to access them often report better outcomes at work. That can mean less job disruption, greater ability to concentrate on tasks and fewer changes to work hours.

Our study suggests that providing benefits and accommodations to workers improves work participation, says Dr. Monique Gignac, an IWH senior scientist and lead author of the study. It also suggests that providing such support is unlikely to drain company resources.

The study, entitled “Availability, need and use of work accommodation and policies,” has been accepted for publication in the journal Arthritis Care and Research.

It’s the first to look in detail at what workers with arthritis need in terms of benefits and accommodations at work, what is available and what is actually used. Even more tellingly, the study provides a glimpse into whether the need, availability and use of specific supports may actually help people do their work.

Workers surveyed

The study involved interviews with 219 working individuals who were 25 years or older, living in Ontario or British Columbia, and had a diagnosis of osteoarthritis or inflammatory arthritis. The sample contained a broad range of individuals in terms of the types of jobs and industries they worked in. The participants also varied in their health conditions; though all had arthritis, some experienced no disability whereas others experienced a fair amount of pain, fatigue and functional limitations. The study asked participants about their access to and use of benefits (i.e. extended health benefits and short-term leave) and accommodations (i.e. flextime, modified schedules, equipment adaptations and work-at-home opportunities).

Overall, only a small proportion reported not being offered any benefits or accommodations (5.5 per cent). That’s a positive indication of the level of support that Canadian workplaces are already providing (see Table 1 in sidebar). Also noteworthy is that one quarter to nearly two thirds of respondents said they didn’t need various types of benefits or accommodation for their arthritis—a sign that not everyone with arthritis finds the condition disabling.

Gignac’s team found that no single benefit or accommodation was seen by everyone as the best. A menu of policies and accommodations is going to be more useful in the long run, says Gignac. Each of these supports may be helpful at least some of the time. There’s not one benefit or accommodation where we can say, ‘Well, employers shouldn’t bother with that.’

The greatest gap between need and availability was in extended health coverage, in which employer-paid health-care programs offer services not usually available through provincial health-care plans, such as physiotherapy, massage and some additional drug coverage. This benefit was the one needed by the largest proportion of respondents (three out of four), but also the one not used by the largest share (one in four) because it was not available.

Looking at the characteristics of respondents who said they needed and used benefits, the team found no difference in terms of age, gender, job tenure or part-time/full-time status. However, college- or university-educated respondents were more likely to use benefits and accommodations, as were those who had told supervisors about their arthritis. In general, people who worked in the sales and service sector or the trades, transportation and equipment operation sector had fewer benefits and accommodations available to them than people in other industries.

Improved work outcomes

The study also analyzed the work outcomes of people who used their workplace supports compared to those who said they would have liked to use supports but they were unavailable. The study found different benefits and accommodations were related to positive workplace outcomes in different ways (see Table 2 in sidebar). Among the notable findings were:

While most people didn’t need short-term leave, those who needed it and used it reported fewer work limitations, job disruptions, productivity losses and reduced hours, compared to people who needed short-term leave but didn’t use it.

Supports such as special equipment, work-at-home arrangements, extended health benefits and short-term leave were associated with people less likely to reduce their working hours.

Flexible hours were related to fewer job disruptions but made little difference to other types of outcomes.

People who needed and used work-at-home arrangements reported less job disruption, productivity loss and reduced hours compared to those who would have liked these arrangements but couldn’t use them, largely because they were unavailable. What’s more, using work-at-home arrangements seemed to put people on par with healthier participants who reported not needing these arrangements. When people with disabling arthritis were able to work at home, it appears their work productivity levels were just the same as people with arthritis who said ‘I’m fine,’ says Gignac.

Although it looks like none of the accommodations examined were associated with reduced absenteeism, that may have been due to how absenteeism was measured. It was a yes or no question asking respondents whether they were absent even for a day in the previous six months due to their arthritis. If respondents were absent for just one day, that shouldn’t necessarily be seen as undesirable, adds Gignac. People with arthritis often tell us that to manage their disease, they need occasional absences for treatment and ongoing medical monitoring and tests. We need to better understand this ‘good’ absenteeism because it may help people remain working in the long term.

Because symptoms of arthritis tend to “flare” (i.e. come and go), Gignac notes that many people will not use benefits and accommodations all of the time, but having these policies available can make an important difference.

There are things employers can do to help, and they’re not things that employers have to design from scratch, says Gignac. A lot of these things are policies or practices that companies are doing for other employees, especially as people age and start to have health problems. But what we’re finding is they can make a difference for people with arthritis as well.